When I tried to change therapists after moving back to the UK, I felt like an employer searching for the perfect, glittery unicorn who’s experiences mirrored mine. I’d either find “LGBTQ+ affirming” therapists who did not understand my blended family or “culturally affirming” therapists who did not understand my gender or sexuality. My success in therapy depends on me not having the explain all of my different intersections.I’ve learned one thing I need when I say I feel alone in POC spaces for being LGBTQ and I feel alone in LGBTQ spaces for being POC, is a nod that tells me they get it because they have felt similar dichotomies. That nod of understanding and relating has to be legit too, not a nod of pity or guilt but a nod of ugh fuck yes I see you in this feeling and the world can be shit lets talk about how everything is connected.

I talk about race and gender a lot. I need to feel like I can say anything to my therapist when it comes to these two topics and not worry that I might offend them. I also need to know that I can speak candidly about how coming into my sexuality has been shaped by my family and South Asian culture, without having to worry that “Asians are homophobes” will be thrown back at me in some politely coded form. If I can’t trust my therapist in this way, then I know that I’m not going to be able to open up about my real issues.

So much of my experience of being a South Asian person who grew up and lives in America is feeling disempowered to make any claims about my own experience. I’ve often been left feeling like I’m not an expert on any kind of cultural or racial identity: I can’t speak to anything about being South Asian because I don’t live on the subcontinent, but I’m not an American because I’m brown. And when it comes to racism, so many of the situations have hinged on these subtleties so I really have no clue what’s going on – is it really racism? I need a therapist who can engage with all of this in a meaningful way without undermining me, whose questions aren’t caught up in the nitty gritty details but rather redirect my focus to how these experiences make me feel.

I’ve had a few therapists over the years. I wish my less helpful therapists had believed that my depression and anxiety have nothing to do with my gender identity or sexual orientation. Yes, I’ve experienced discrimination and rejection based on my queer identity, but that’s never been why I’ve sought mental health support. I’m a lucky gay duck — I’ve never felt any internal conflict or shame around my queerness. I deal with classic, run-of-mill worries and sadness without any rainbow flags attached. Yet some of my (straight, well-meaning) therapists have spent our sessions circling back to gender and sexuality when there have been more relevant, pressing issues to focus on. That’s frustrating. I need a therapist who lets me lead them to the root of my problems without making any assumptions.


So I’m not currently in therapy but am desperately seeking it. I’m somewhere between pissed and exhausted at how hard the search has been because I live in New York City and am astonished at how few therapists take my insurance, how many practitioners define sliding scale as “$200-$250” a session, and how often I have to prioritize either my race or sexuality in looking for a therapist. I have been lucky in the past to have a couple of really good queer therapists who were cis White men, but unfortunately I’ve had to break up with a fair share of therapists. I didn’t do the best job of ending it, so I would tell each of them the following:

• If you don’t actually hold any competency in issues of racial, sexual, and gender diversity then please openly admit what you don’t know. I have experienced more than one therapist attempt to use me as a learning tool rather than simply admit to any gaps in their knowledge. The most glaring case was in a cis straight White woman asked me if I was thinking about race because of the day’s occasion. It was MLK day. I had to explain that, as a Black woman, I don’t have the luxury of only thinking about race on MLK day and during Black History Month.
• It’s okay and actually necessary for me to be angry sometimes. It’s actually incredibly fucked up and triggering to be told I should “move past” my anger because it’s not productive. The angry Black woman trope already exists to shame Black women out of our feelings, specifically our righteous indignation. While I certainly recognize one can’t stay in anger, as my therapist you should especially be attuned to the need to express anger with the many systems working to oppress me.
• Like others have said, my anxiety isn’t a result of my queerness or my Blackness. While my experiences of marginalization don’t help my condition, I have felt pushed to claim feelings of being ashamed or conflicted by my queerness when that either hasn’t been the case or isn’t the central issue I want to discuss.

I didn’t switch therapists when I transitioned. I’d established a really nice relationship with my therapist and even though she was cis and straight what I really needed in that tumultous time was someone who knew me and knew how my anxiety and depression manifested. But when I moved to LA and had the opportunity to find a new therapist I knew I wanted to find someone who was queer. My current therapist is cis and bisexual and there is something so nice about having a therapist who understands queer culture. I feel like I can trust her judgement on certain things in a way I maybe couldn’t with my previous therapist. 

But she is still cis and there is a bit of a divide there. It’s not that she isn’t well-educated on transness. She just sometimes reacts to certain things with what feels like a sense of pity. I think a lot of cis people connote transness with tragedy, because of the larger cultural narrative and sometimes when I talk about something and she gets that sad cis look I want to be like I’m okay! It’s okay! I might be having a problem that’s specifically related to my transness, but it’s just like any of my other problems. It’s not heavier, because it’s about being trans. 

I should probably just say this to her! I always want my therapists to like me so badly, I sometimes don’t say things I should. This has inspired me. Next time she does this I’m going to explain why it bothers me.

I have been in therapy, on and off, for over a decade, but each new phase of my journey has required a different therapist. At first I was only — well, “only” — in therapy to understand my mom’s personality disorder. I began with a Christian counselor who quickly became irrelevant because I left the church and realized she was just regurgitating Proverbs 31 nonsense to me anyway. Getting a secular therapist was a big deal! And then, when I came out, getting a gay-affirming therapist was a big deal! I spent most of my life in rural Georgia, the reddest county in the entire country — truly, these actually were big deals. 

When I moved to New York City, it felt like any therapist would do, because they were all, seemingly, well-versed in “LGBT issues.” I guess for a long time I didn’t really have a problem because I was seeking out therapists for specific things I was tackling — strategies for managing my anxiety, inner child work, career counseling — and none of it had anything to do with my sexuality. I’m cis and white and in a healthy and monogamous longterm relationship. Pretty mainstream narratives.

When I started to need to see a therapist regularly in 2016, to grapple with just so many things as they were happening in real time and with how my reactions were informed by my childhood trauma, it quickly became apparent that I was going to have to do more than select whatever therapist called me back first after I selected “five mile radius” on my insurance’s search portal. Just off the top of my head, here are some things I’ve perpetually had trouble making therapists understand: 

It doesn’t matter if it affects me directly; if it affects any oppressed person, it is deeply troubling and unacceptable to me and I want to figure out my role in combatting it. No, I cannot just “wait and see” what happens, because that is a luxury, and many people in my community will be hurt by my delayed action. Yes, I would probably be happier if I didn’t “seek out upsetting news” or if I remained silent sometimes, but freedom for everyone is my life’s purpose, not some kind of deliberately obtuse happiness. (Choosing ignorance is not self-care.) (Complacency is not contentment.) Terrible people can be part of accomplishing good things on a large scale in activist groups, but that does not diminish their abuses. The political is very personal to me, and I don’t know how to relate to anyone — including my own family — who do not feel the same way. It is my responsibility and my privilege to use my relative power to empower other people, to lift them above me, and that doesn’t mean I am giving up my own goals and dreams. Being sweet is a passive personality trait; being kind is a courageous and minute-by-minute choice. No, I don’t need to explore my general contempt for cis men. I can be full of so much rage and also full of so much tender, precious, gentle love. My wounds, as Adrienne Rich says, come from the same source as my power; I can’t close off one without closing off the other. 

I was recently thrown by a new trauma therapist I was getting along with quite well defending someone I was explaining was hurting a very vulnerable group of people in our community. I thought, at first, she didn’t understand what I was saying. I explained further, and still further. But no, she got it. She “just couldn’t” with the most basic expression of respecting the humanity of these folks. I took some books to her office a few days later, some resources for her to educate herself, and I told her I couldn’t see her anymore. 

She emailed me a few days later, to tell me she was having a hard time wrapping her mind around how she’d upset me so, and I told her that was for her to work out with someone else, and that I did not owe her any further explanation. So: therapy has also done very good things for me! 

I’ve been very lucky to mostly have therapists who, while straight, did at least know the basics about LGBT cultural competency (with the exception of once trying to access a graduate student mental health service, where they told me they would try to get me a woman therapist but couldn’t guarantee it and I might “end up having to educate a bit” on LGBT issues. I did not continue services with them.). In my experience even with those therapists, though, I sometimes wish they would be a little more willing to know how much they don’t know, and can’t. Which is fine! No one can be an expert on a lived experience they don’t have, and they shouldn’t try to. I still find myself, though, often leaving out or glossing over specifically queer stuff in therapy because I don’t trust that it won’t be misinterpreted, or that the therapist’s ideas about what queerness is and how it functions won’t overshadow my own actual experiences.

As an example, I have a specific memory of relating to a therapist an anecdote from my youth about an early same-sex relationship I had, in which I offhandedly mentioned that neither of us had been out at the time. My therapist was fascinated by this, and couldn’t let go of it — I think in her received narrative about how coming out works, a queer person comes out formally to their entire family and social circle as soon as they “know” their identity barring any immediate concrete risks of violence or homelessness, and could not fathom why I hadn’t; this became the whole story to her, and my decision around out-ness clearly indicative of some larger theme or issue — when of course it isn’t, and also that wasn’t what I was actually trying to talk about at all, and the issue I actually needed to focus on got derailed. Lots of people come out (or don’t) in lots of ways; sometimes it’s for a specific reason, in this case it genuinely wasn’t, and wasn’t an important choice. Based on experiences like this, though, I find myself often shying away from getting in depth about the more “advanced topics” in queerness – how it impacts my relationships, how stigma or internalized stuff impacts my decisionmaking or how I experience myself, experiences around sexuality or my body, how my identity and developmental trauma interact with each other – because I worry that pretty common, unremarkable parts of a queer existence will be read as a pathology or aberration just because they’re not easily legible to a straight person.

I’d feel more confident about navigating this stuff with a straight therapist if I knew they had a sense of treating me as the expert on my own experience when it comes to queerness, committing to doing more listening than talking on things related to queerness specifically, and being willing to suspend some disbelief for things that don’t immediately make sense to them, (or maybe even research and learn more about them on their own time, without my having to do a quick 101 in session on my own dime!). In a lot of parts of the therapeutic process I think it’s important for me to understand I might be wrong, and my therapist might have insights or perspective that I don’t — but not on this topic, where coming up with new hot takes is more likely to do harm than good.

My current therapist is a queer woman of color, which I’ve never had before and which has been literally life-changing. I had to fight for months with my insurance to get our sessions covered, though – and now my employer changed insurance providers and she’s not covered anymore. So to be honest, what I really wish is that insurance companies understood that seeing a therapist who shares one or more of our identities is crucially important and to quit fighting us on it?

But I’ve been in therapy for many years, and many of my therapists have been pretty bad (for me). My current therapist is amazing, but I would like my past, bad therapists to know:

• Telling me that other people, like starving children in developing countries, have it worse than I do isn’t an effective way to help me address my depression. Suffering is contextual.
• I’m not depressed because I’m trans. That being said, the persistent discrimination I experience because I’m trans surely does contribute to my depression.
• Just because I can expect discrimination as a part of my life as a trans person doesn’t mean I have to be OK with it. It’s normal and natural for me to be bothered by it even if there’s nothing I can do about it. Not everything has to be accepted and tolerated in order for me to live a happy, healthy life.

Anyway, my current therapist doesn’t get into any of this bullshit, is nerdy and thoughtful and listens and challenges me and she has literally changed my life. If there’s a QTPOC therapist in your area, challenge your insurance company to see if you can get out-of-network coverage – it could happen!